Department of Trauma, Hand and Reconstructive Surgery, University of Giessen and Marburg GmbH, Marburg, Germany.
Maturitas. 2013 Feb;74(2):185-9. doi: 10.1016/j.maturitas.2012.11.003. Epub 2012 Dec 5.
The number of agile patients in the 10th decade with a strong need for postoperative mobility will increase in the following decades. The present prospective study sought to prove if very old patients with hip-related fractures are disadvantaged according to incidence of complications, length of ICU and in-hospital stay, and in-hospital mortality. We included 402 patients, age 60 years and older, with hip related fractures. Operative treatment consisted of osteosynthesis or endoprothesis. ASA score, body mass index, Charlson Comorbidity Index, Barthel Index and Mini-Mental-Status were documented. We noted length of in-hospital stay and ICU stay as well as readmission to ICU and complications, including their dispersal according to Clavien-Dindo Classification. After univariate analysis, a multivariate analysis was performed. The examined cohorts were 85 patients aged 60-74 years, 253 75-90 years old and 64 >90 year old patients. In-hospital periods (13-14 days) mean stay on ICU (2 days) and frequency of readmission on ICU did not significantly differ statistically. Most complications were grade II, with comparable frequency and modality, displaying no significant difference throughout age-related groups (p=0.461). In-hospital mortality showing significance (p=0.014) only between 75-89 (4.4%) and >90-year-old (12.5%) cohort. Nevertheless, according to multivariate analysis, including the common risk factors, increased age was not an independent risk factor for dying (p=0.132). Patients at an advanced age with hip-related fractures showed neither a prolonged in-hospital nor ICU stay. There was no significant relation of advanced age to number and type of complications.
在未来几十年,第十个十年中需要术后活动能力的敏捷患者数量将会增加。本前瞻性研究旨在证明年龄较大的髋部骨折患者是否在并发症发生率、重症监护病房和住院时间以及住院死亡率方面处于不利地位。我们纳入了 402 名年龄在 60 岁及以上的髋部相关骨折患者。手术治疗包括内固定或假体置换。记录了美国麻醉医师协会(ASA)评分、体重指数、Charlson 合并症指数、巴氏指数和简易精神状态检查(MMSE)。我们记录了住院时间和重症监护病房(ICU)停留时间,以及 ICU 再次入院和并发症,包括根据 Clavien-Dindo 分类的分布情况。在单变量分析后,进行了多变量分析。检查队列包括 85 名年龄在 60-74 岁的患者、253 名 75-90 岁的患者和 64 名>90 岁的患者。住院期间(13-14 天)的 ICU 平均停留时间(2 天)和 ICU 再次入院的频率在统计学上没有显著差异。大多数并发症为 II 级,在不同年龄组之间具有相似的频率和模式,没有显著差异(p=0.461)。住院死亡率具有显著差异(p=0.014),仅在 75-89 岁(4.4%)和>90 岁(12.5%)组之间。然而,根据包括常见危险因素的多变量分析,年龄增加并不是死亡的独立危险因素(p=0.132)。年龄较大的髋部相关骨折患者住院时间和 ICU 停留时间均无明显延长。年龄较大与并发症的数量和类型之间没有显著关系。